Care Delivered by Pediatric Surgical Specialties Through Patient Portal Messaging

Riera, Katherine M; Robinson, Jamie R.; Arendonk, Kyle J. Van; Jackson, Gretchen Purcell

doi:10.1016/j.jss.2018.09.013

Cited by 13 publications

(8 citation statements)

References 24 publications

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“…There is mixed evidence in the literature of how secure messaging could be used clinically. Only 1 study with children and adolescents with sickle cell disease found that messaging was used for proactive check-ins and sharing of educational information [14], whereas a study with pediatric surgical patients did not [26]. Considering the current literature, our findings suggest that children with higher care needs and chronic conditions, such as those with medical complexity and those with sickle cell disease, benefit from the use of secure messaging as it allows for proactive check-ins from their CTMs as well as continued education surrounding their medical conditions.…”

Section: Principal Findingsmentioning

confidence: 99%

Evaluation of a Secure Messaging System in the Care of Children With Medical Complexity: Mixed Methods Study

Parpia¹,

Moore²,

Beatty³

et al. 2023

JMIR Form Res

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Background The Connecting2gether (C2) platform is a web and mobile–based information-sharing tool that aims to improve care for children with medical complexity and their families. A key feature of C2 is secure messaging, which enables parental caregivers (PCs) to communicate with their child’s care team members (CTMs) in a timely manner. Objective The objectives of this study were to (1) evaluate the use of a secure messaging system, (2) examine and compare the content of messages to email and phone calls, and (3) explore PCs’ and CTMs’ perceptions and experiences using secure messaging as a method of communication. Methods This is a substudy of a larger feasibility evaluation of the C2 platform. PCs of children with medical complexity were recruited from a tertiary-level complex care program to use the C2 platform for 6 months. PCs could invite CTMs involved in their child’s care to register on the platform. Messages were extracted from C2, and phone and email data were extracted from electronic medical records. Quantitative data from the use of C2 were analyzed using descriptive statistics. Messaging content codes were iteratively developed through a review of the C2 messages and phone and email communication. Semistructured interviews were completed with PCs and CTMs. Communication and interview data were analyzed using thematic analysis. Results A total of 36 PCs and 66 CTMs registered on the C2 platform. A total of 1861 messages were sent on C2, with PCs and nurse practitioners sending a median of 30 and 74 messages, respectively. Of all the C2 messages, 85.45% (1257/1471) were responded to within 24 hours. Email and phone calls focused primarily on clinical concerns and medications, whereas C2 messaging focused more on parent education, proactive check-ins, and nonmedical aspects of the child’s life. Four themes emerged from the platform user interviews related to C2 messaging: (1) connection to the care team, (2) efficient communication, (3) clinical uses of secure messaging, and (4) barriers to use. Conclusions Overall, our study provides valuable insight into the benefits of secure messaging in the care of children with medical complexity. Secure messaging provided the opportunity for continued family teaching, proactive check-ins from health care providers, and casual conversations about family and child life, which contributed to PCs feeling an improved sense of connection with their child’s health care team. Secure messaging can be a beneficial additional communication method to improve communication between PCs and their care team, reducing the associated burden of care coordination and ultimately enhancing the experience of care delivery. Future directions include the evaluation of secure messaging when integrated into electronic medical records, as this has the potential to work well with CTM workflow, reduce redundancy, and allow for new features of secure messaging.

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Section: Principal Findingsmentioning

confidence: 99%

Evaluation of a Secure Messaging System in the Care of Children With Medical Complexity: Mixed Methods Study

Parpia¹,

Moore²,

Beatty³

et al. 2023

JMIR Form Res

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“… 26 Electronic messages for care delivery are being used in primary care pediatrics, medical specialties, and surgical specialties. 18 , 19 , 27 Perceptions of portals as a communication tool vary by patient characteristics, including diagnoses. 28 Parents of chronically ill children report that portals are helpful to facilitate communication with their child's clinician.…”

Section: Benefits Of Using Patient Portalsmentioning

confidence: 99%

Patient portals for the adolescent and young adult population: Benefits, risks and guidance for use

Lee

Holland-Hall

2021

Current Problems in Pediatric and Adolescent Health Care

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“…30 Among a sample of patient portal messages sent to pediatric surgical subspecialists, 42% of messages addressed appointments and scheduling, with many of these messages also addressing other clinical needs at the same time. 31 However, use of patient portals remains low 32 and differences exist in portal use by education level and by insurance. 32 Adoption overall and within underserved populations needs to be addressed for portals to meaningfully contribute to addressing barriers within the scheduling process.…”

Section: Appointment Schedulingmentioning

confidence: 99%

“…Finally, patient portals can provide a platform for both patient data reporting and family-to-subspecialist electronic messages between visits, allowing enhanced communication on topics ranging from logistical to medical to social concerns. 31…”

Section: Post-consultative Communication and Care Integrationmentioning

confidence: 99%

Connected Subspecialty Care: Applying Telehealth Strategies to Specific Referral Barriers

Ray

Kahn

2020

Academic Pediatrics

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Nearly a quarter of families of children with need of subspecialty care report difficulty accessing that care. Telehealth is a method to overcome barriers to subspecialty care. However, improving access to subspecialty care through telehealth requires granular identification of specific subspecialty barriers and recognition of the strengths and limitations of each telehealth strategy for addressing identified barriers. Focusing on each sequential step in subspecialty referrals and potential associated barriers, we summarize specific telehealth and technology-enabled strategies to improve access to subspecialty care, including electronic consultations, live interactive telemedicine, store-and-forward telemedicine, tele-mentoring, patient portals, and remote patient monitoring. Intentionally selecting telehealth strategies to target specific subspecialty referral barriers may avoid risks from misapplication of telehealth, may more clearly elevate equitable access as an essential goal within telehealth initiatives, and may also lead to synergistic use of strategies that overcome sequential barriers.Pediatric subspecialty referrals involve a series of steps, with breakdown in any of these processes impairing access to care. [1][2][3] An ideal referral begins with an initial referral decision, followed by a pre-visit transfer of information. Appointment scheduling is then followed by the consultative visit itself. Optimal referrals then include post-consultative communication and finally ongoing integration of care between primary care, subspecialty care, and the patient and family. [1][2][3]

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Care Delivered by Pediatric Surgical Specialties Through Patient Portal Messaging

Cited by 13 publications

References 24 publications

Evaluation of a Secure Messaging System in the Care of Children With Medical Complexity: Mixed Methods Study

Evaluation of a Secure Messaging System in the Care of Children With Medical Complexity: Mixed Methods Study

Patient portals for the adolescent and young adult population: Benefits, risks and guidance for use

Connected Subspecialty Care: Applying Telehealth Strategies to Specific Referral Barriers

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